# Patent

## Title
Visual indication of alarms on a ventilator graphical user interface

## Abstract

This disclosure describes systems and methods for displaying alarms to a clinician in a ventilatory system. Specifically, embodiments described herein seek to optimize the informative presentation of alarms on a ventilator interface. Embodiments of the present disclosure may provide one or more selection elements, each selection element indicating a ranked alarm event. The ranking of an alarm event may be determined by alarm level. If two alarm events are associated with the same alarm level, the ranking of the alarm events may be determined by parameter priority. Alarm event ranking is communicated by display in a hierarchical structure. When an alarm event ranking changes, the alarm event may shift up or down the hierarchical structure, depending on whether the ranking increased or decreased.

## Background
RELATED APPLICATIONS
This application claims benefit under 35 U.S.C. §119(e) to U.S. Provisional Application No. 61/287,914 entitled “Graphical User Interface for Use on Medical Ventilator” filed on Dec. 18, 2009 the entire disclosure of all of which is hereby incorporated herein by reference.


INTRODUCTION
A ventilator is a device that mechanically helps patients breathe by replacing some or all of the muscular effort required to inflate and deflate the lungs. During ventilation, the ventilator may be configured to generate various alarms upon detecting a change in the patient's condition, a malfunction of the ventilatory equipment, or other indication that clinician intervention may be warranted. Thus, alarms generally function to alert a clinician of an abnormal or unsafe condition that may impact the patient. In this sense, alarms are a very important and necessary feature of any therapeutic instrument. However, alarms may not convey enough information regarding which alarms need to be alleviated first. In addition, multiple simultaneous alarms may compound this insufficiency of alarm information, costing the clinician valuable time while deciding which alarm to address first.
Visual Indication of Alarms on a Ventilator Graphical User Interface
The disclosure describes improved systems and methods for displaying alarms to a clinician in a ventilatory system. Specifically, embodiments described herein seek to optimize the informative presentation of alarms on a ventilator interface. Embodiments of the present disclosure may provide one or more selection elements, each selection element indicating a summarized alarm message. The summarized alarm message may include a parameter indication, an alarm event indication, and an alarm level indication. The one or more summarized alarm messages are associated with ranked alarm events. The most highly ranked alarm event is displayed in a selection element at the top of a hierarchical display, with the next most highly ranked alarm event displayed below it in descending order of rank. An alarm event's ranking is determined, first by the alarm level. In some embodiments, alarm events are associated with high, medium or low alarm levels. If an alarm event is the only alarm event associated with a high alarm level, it will be ranked highest and displayed in the selection element at the top of the hierarchical display. However, if two alarm events are both associated with a high alarm level, a ranking determination is made by comparing the parameter priority associated with each alarm event. Each ventilatory parameter is assigned a priority level. In the case of identical alarm levels, the alarm event associated with the parameter with the highest parameter priority will be ranked higher.
Alarm event rankings can change over time. For example, an alarm level for a given alarm event can elevate or de-elevate, depending on the condition of the patient. When an alarm event's ranking changes, the hierarchical display of alarm events is rearranged to reflect the new ranking. As will be appreciated, all alarm events, such as an alarm event with a low ranking, may not be provided in the graphical display. As a result, if an alarm event's ranking drops enough, it may disappear from the graphical display completely and a new alarm event may replace it. In some embodiments, the rearrangement is displayed by “floating” the alarm messages either up or down the hierarchical display based on whether the ranking has increased or decreased.
Other embodiments of the present disclosure provide for an expanded alarm message. Upon accessing a selection element in the hierarchical display, a clinician can ascertain more information about the alarm event including, but not limited to, suggested alarm alleviation measures, detailed alarm event description, and a hyperlink to an alarm settings window. In one embodiment, a clinician can access the hyperlink to access an alarm settings window providing more information about all the alarms. As discussed above, the graphical display may not display all currently emitting alarms. The alarm settings window provides the clinician with information about all currently emitting alarms with user adjustable parameters. The alarm settings window may also provide the clinician with an opportunity to adjust alarm settings for each ventilatory parameter.
Other embodiments of the present disclosure provide for an alarm log window. The alarm log window provides a clinician with a temporal log of all alarm events. In one embodiment, the alarm log window records all alarm events since manual reset of the ventilator. In another embodiment, the alarm log window records all alarm events since the ventilator began monitoring a new patient.
These and various other features as well as advantages which characterize the systems and methods described herein will be apparent from a reading of the following detailed description and a review of the associated drawings. Additional features are set forth in the description which follows, and in part will be apparent from the description, or may be learned by practice of the technology. The benefits and features of the technology will be realized and attained by the structure particularly pointed out in the written description and claims hereof as well as the appended drawings.
It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory and are intended to provide further explanation of the invention as claimed.



BRIEF DESCRIPTION OF THE DRAWINGS
The following drawing figures, which from a part of this application, are illustrative of described technology and are not meant to limit the scope of the invention as claimed in any manner, which scope shall be based on the claims appended hereto.
FIG. 1 is a diagram illustrating an embodiment of an exemplary ventilator connected to a human patient.
FIG. 2 is a block-diagram illustrating an embodiment of a ventilatory system having a graphical user interface for displaying structured and informative alarms.
FIG. 3 is an illustration of an embodiment of a user interface for hierarchically indicating alarms on a graphical display.
FIG. 4 is an illustration of an embodiment of a user interface for displaying an expanded alarm tab.
FIG. 5 depicts an alarm setup window for display in user interface.
FIG. 6 depicts an alarm log window for display in user interface.



DETAILED DESCRIPTION
Although the techniques introduced above and discussed in detail below may be implemented for a variety of medical devices, the present disclosure will discuss the implementation of these techniques for use in a mechanical ventilator system. The reader will understand that the technology described in the context of a ventilator system could be adapted for use with other therapeutic equipment having user interfaces, including graphical user interfaces (GUIs), for prompt startup of a therapeutic treatment.
This disclosure describes systems and methods for displaying alarms to a clinician in a ventilatory system. Specifically, embodiments described herein seek to optimize the informative presentation of alarms on a ventilator interface. Embodiments of the present disclosure may provide one or more selection elements, each selection element indicating a ranked alarm event. The ranking of an alarm event may be determined by alarm level. If two alarm events are associated with the same alarm level, the ranking of the alarm events may be determined by parameter priority. Alarm event ranking is communicated by display in a hierarchical structure. When an alarm event ranking changes, the alarm event may shift up or down the hierarchical structure, depending on whether the ranking increased or decreased.
As such, the present disclosure provides an institution or clinician with optimal control over routine ventilatory settings. Specifically, routine layout configuration settings may be preconfigured according to a hospital-specific, clinic-specific, physician-specific, or any other appropriate protocol. Moreover, layout configuration settings may be changed and edited in response to a particular patient's changing needs and/or condition.
FIG. 1 illustrates an embodiment of a ventilator connected to a human patient 150. The ventilator includes a pneumatic system 102 (also referred to as a pressure generating system 102) for circulating breathing gases to and from patient 150 via the ventilation tubing system 130, which couples the patient to the pneumatic system via an invasive patient interface (e.g., endotracheal tube).
Ventilation tubing system 130 may be a two-limb (shown) or a one-limb circuit for carrying gas to and from the patient 150. In a two-limb embodiment as shown, a fitting, typically referred to as a “wye-fitting” 170, may be provided to couple the patient interface to an inspiratory limb 132 and an expiratory limb 134 of the ventilation tubing system 130.
Pneumatic system 102 may be configured in a variety of ways. In the present example, system 102 includes an expiratory module 108 coupled with the expiratory limb 134 and an inspiratory module 104 coupled with the inspiratory limb 132. Compressor 106 or other source(s) of pressurized gases (e.g., air, oxygen, and/or helium) is coupled with inspiratory module 104 to provide a gas source for ventilatory support via inspiratory limb 132.
The pneumatic system may include a variety of other components, including sources for pressurized air and/or oxygen, mixing modules, valves, sensors, tubing, accumulators, filters, etc. Controller 110 is operatively coupled with pneumatic system 102, signal measurement and acquisition systems, and an operator interface 120 that may enable an operator to interact with the ventilator (e.g., reset alarms, change ventilator settings, select operational modes, view monitored parameters, etc.). Controller 110 may include memory 112, one or more processors 116, storage 114, and/or other components of the type commonly found in command and control computing devices.
The memory 112 is computer-readable storage media that stores software that is executed by the processor 116 and which controls the operation of the ventilator. In an embodiment, the memory 112 includes one or more solid-state storage devices such as flash memory chips. In an alternative embodiment, the memory 112 may be mass storage connected to the processor 116 through a mass storage controller (not shown) and a communications bus (not shown). Although the description of computer-readable media contained herein refers to a solid-state storage, it should be appreciated by those skilled in the art that computer-readable storage media can be any available media that can be accessed by the processor 116. Computer-readable storage media includes volatile and non-volatile, removable and non-removable media implemented in any method or technology for storage of information such as computer-readable instructions, data structures, program modules or other data. Computer-readable storage media includes, but is not limited to, RAM, ROM, EPROM, EEPROM, flash memory or other solid state memory technology, CD-ROM, DVD, or other optical storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other medium which can be used to store the desired information and which can be accessed by the computer.
As described in more detail below, controller 110 may monitor pneumatic system 102 in order to evaluate the condition of the patient and to ensure proper functioning of the ventilator based on various parameter settings. The specific parameter settings may be based on preconfigured settings applied to the controller 110, or based on input received via operator interface 120 and/or other components of the ventilator. In the depicted example, operator interface 120 includes a display 122 that is touch-sensitive, enabling the display to serve both as an input and output device.
FIG, 2 is a block-diagram illustrating an embodiment of a ventilatory system 200 having a graphical user interface for displaying structured and informative alarms.
The ventilator 202 includes a display module 204, memory 208, one or more processors 206, user interface 210, and ventilation module 212. Memory 208 is defined as described above for memory 112. Similarly, the one or more processors 206 are defined as described above for the one or more processors 116. Ventilation module 212 may oversee ventilation as delivered to a patient according to the ventilatory settings prescribed for the patient. For example, ventilation module 212 may deliver pressure and/or volume into a ventilatory circuit, and thereby into a patient's lungs, by any suitable method, either currently known or disclosed in the future.
The display module 204 presents various input screens and displays to a clinician, including but not limited to one or more structured alarm displays, as will be described further herein, for receiving clinician input and for displaying useful clinical data and alerts to the clinician. The display module 204 is further configured to communicate with user interface 210. The display module 204 may provide various windows and elements to the clinician for input and interface command operations. Additionally, user interface 210 may accept commands and input through display module 204 and may provide useful alarm information to the clinician through display module 204. Display module 204 may further be an interactive display, whereby the clinician may both receive and communicate information to the ventilator 202, as by a touch-activated display screen. Alternatively, user interface 210 may provide other suitable means of communication with the ventilator 202, for instance by a keyboard or other suitable interactive device.
Alarm display module 214 may be useful for providing comprehensive alarm information and access to alarm settings and data on a graphical user interface (GUI) of the ventilator, as may be provided by display module 204. Specifically, a hierarchical alarm structure may be provided in which a summarized alarm message may be initially presented and, upon clinician selection, an additional detailed alarm message may be displayed. The summarized alarm message may further provide comprehensive information to the clinician in abbreviated form, for example the seriousness of an alarm message may be communicated via various icons and exclamation indicators and the priority of the alarm message vis-à-vis other alarm messages may be communicated via the relative graphical placement of the alarm message.
Additionally, a summary and/or detailed alarm message may provide immediate access to the display and/or settings window associated with an alarm event. For example, an associated alarm settings window may be accessed from an alarm message via a hyperlink such that the clinician may reconfigure alarm conditions as necessary. The alarm settings window allows a clinician to view patient information for various ventilatory parameters, even those parameters that are not currently associated with an alarm event. In this way, the clinician may access additional information regarding patient respiration.
In order to accomplish the various aspects of the hierarchical informative alarm display, the alarm display module 214 may communicate with various other components and/or modules. For instance, an alarm settings module 228 may be provided. Alarm settings module 228 may monitor the various settings and other input provided by a clinician to the ventilator via the user interface 210 or display module 204. Alarm settings module 228 may compare and evaluate parameter settings entered by the clinician according to any suitable method or procedure. For example, alarm settings module 228 may detect when patient settings are missing or otherwise inappropriate for a particular input field. Inappropriate parameter settings may be indicated where settings entered for different parameters are inconsistent, e.g., one parameter setting indicates that the patient is a child, while another parameter setting indicates that the patient is an adult male, etc. In addition, alarm settings module 228 may evaluate parameter data received from monitor module 230 against the settings associated with the monitored parameters. When alarm settings module 228 determines that the parameter data falls outside applicable settings and ranges, alarm settings module 228 may communicate with alarm display module 214, or other modules of the alarm display module 214, in order to generate an informative alarm message.
Alarm display module 214 may also be configured with a hierarchical display module 216. The hierarchical display module 216 may be in communication with the monitor module 230 and/or alarm settings module 228 to receive an indication that an alarm event has occurred. The hierarchical display module 216 may be responsible for generating a multi-level alarm message via any suitable means. For example, a first level summary alarm message may be provided as a tab, banner, dialog box, or other similar type of display. Further, a summary alarm messages may be provided along a border of the graphical user interface that is either blank or that displays minimally important information. The shape and size of the summary alarm message may also be optimized for easy viewing with minimal interference. The summary alarm message may be further configured with a combination of icons and text such that the clinician may readily identify the priority of the alarm message.
Hierarchical display module 216 may be preconfigured with various summary messages or alarm descriptions corresponding to each general type of alarm event. General summary messages may also be preconfigured to provide abbreviated information to a clinician. For example, when a pressure reading indicates that the peak pressure setting has been breached, an abbreviated summary message may be displayed: “↑Ppeak.” This abbreviated summary message may provide both an indication that a high limit was breached, i.e. by the ↑ indicator, and an abbreviated indication of the particular breached parameter, i.e. by the PPeak notation. The same general summary message may also include explanatory information regarding the particular breach, for instance: “↑PPeak−High Inspiratory Pressure.” In general, a summary level alarm message may be provided in any suitable position on the screen, by any suitable means, such that a general description of an alarm event and/or its gravity may be efficiently communicated to a clinician.
The hierarchical display module 216 may also generate a selectively accessed second level alarm message. The second level alarm message may provide additional details and information regarding the alarm event and may be accessible from the first level summary alarm message. Second level alarm messages may be preconfigured with a detailed alarm message or description corresponding to various types of alarm events. For example, a detailed alarm message may provide possible reasons for an alarm breach, suggested checks or procedures for mitigating the alarm, or other helpful information. Additionally, other embodiments may provide for semi-custom detailed alarm messages. For instance, portions of a detailed alarm message may be preconfigured for similar types of alarm events, while other portions may provide variable fields that may be populated with more specific information regarding a particular breach, for instance the extent that a parameter was breached, the number of breaths over which the breach occurred, whether a maximum or minimum parameter setting was breached, etc.
Alarm display module 214 may also be configured with a translucent display module 218. Translucent display module 218 may allow for display of the summary alarm message and/or the detailed alarm message such that displayed respiratory data may be visualized behind the alarm message. This feature may be particularly useful for displaying the detailed alarm message. As described previously, alarm messages may be displayed in areas of the display screen that are either blank or that cause minimal distraction from the respiratory data and other graphical representations provided by the GUI. However, upon selective expansion of a detailed alarm message, respiratory data and graphs may be at least partially obscured. As a result, translucent display module 218 may provide the detailed alarm message such that it is partially transparent. Thus, graphical and other data may be visible behind the detailed alarm message.
Alarm display module 214 may also be configured with a selective display module 220. As discussed above, a detailed alarm message may be selectively displayed in order to offer additional information or details regarding an alarm event to a clinician. According to some embodiments, the second level detailed alarm message may be activated by clicking on the first level display message, touching a portion of the message, or otherwise. Additionally or alternatively, the first level summary alarm message may provide an arrow, or some other feature or icon for selection or activation of the detailed alarm message. Thus, a general summary alarm message may expand upon selection to provide a detailed alarm message. The detailed alarm message may be provided as a tab, banner, dialog box, or other similar type of display, which may extend from behind the general summary alarm message upon selection. In addition, according to some embodiments, the detailed alarm message may be condensed upon selection of an arrow, or some other feature or icon, via touching, clicking, or otherwise. Upon clearing or otherwise resetting an alarm following an alarm event, the summary alarm message and the detailed alarm message may also be cleared from the graphical user interface.
Alarm display module 214 may also be configured with an icon display module 222. Icon display module 222 may provide various icons and other identifiers that may communicate additional abbreviated information to a clinician, for instance regarding the alarm level. An alarm level reflects the seriousness or priority of an alarm message. For instance, “!!!” may be represented in a corner, or other visible area, of the general summary message and may indicate that the alarm is a “High” alarm level and, therefore, is relatively serious. Alternatively, while “!!” or “!” may indicate that the alarm is a “Medium” or “Low” alarm level and is, therefore, less serious. In other embodiments, a number, letter, or other priority icon may be provided to communicate the priority of an alarm message vis-à-vis other displayed alarm messages. In still other embodiments, a status icon may be provided such that the status of an alarm message may be communicated, for instance, an active status or an inactive status, a high or low status, etc. Status may also refer to the number of times during a time period that the same alarm has occurred. In still other embodiments, an up-arrow, e.g., “∇,” or a down-arrow, e.g., “↓,” may be provided to communicate whether a high or low limit was breached, respectively. Indeed, any number or combination of icons or other indicators may be employed to communicate additional, abbreviated information to a clinician,
Alarm display module 214 may also be configured with a prioritized display module 224. As noted above, multiple alarm events may occur at the same or similar time. In this case, it may be useful for the clinician to readily determine which alarm events are of higher priority and should be addressed more quickly. The present disclosure provides for presentation of one or more pending alarms events in a vertical array, for example, that may convey an alarm event ranking and/or status. According to some embodiments, higher ranked alarm events may be presented above other alarm events. Thus, based on a graphical placement of alarm events relative to other alarm events, additional information regarding the priority or status of alarm events relative to other alarm events may be communicated to a clinician.
As will be discussed in further detail below, prioritized display module 224 is configured to rank an alarm event. The ranking of an alarm event determines whether the alarm event will be displayed in an alarm tab and, if so, where the alarm tab displaying the alarm event will be placed in the hierarchical display structure. Alarm event ranking is based on first, an alarm level and second, a parameter priority. An alarm event with a “High” alarm level will be assigned a higher ranking than an alarm event with a “Medium” or “Low” alarm level. If two alarm events have the same alarm level, ranking will be based on a predetermined parameter priority. Each ventilator parameter is assigned a priority. The assignment of parameter occurring may be done by a clinician during ventilator setup. A parameter priority may also be assigned automatically according to a hospital protocol. When two alarm events have the same alarm level, the alarm event with the higher parameter priority will be assigned the higher ranking.
Alarm display module 214 may also be configured with a hyperlink module 226. Hyperlink module 226 may be configured to provide access from the various hierarchical alarm messages to various settings and display screens associated with an identified alarm event. For example, an icon or other link indicator may be provided in either the summary alarm message and/or the detailed alarm message that may be activated or otherwise selected. Upon selection, the icon may provide direct access, via a hyperlink or otherwise, to associated settings or display screens corresponding to a particular alarm event. When access to a settings screen is provided, the clinician may reset the alarm following clinician intervention or may reconfigure alarm settings as appropriate. When access to a display screen is provided, the clinician may view additional information and respiratory data regarding the alarm event. Hyperlink module 226 may further provide access to any useful display screen, settings screen, or other graphical user interface available on the ventilator that is associated with a particular alarm event.
Monitor module 230 may operate to monitor the physical condition of the patient in conjunction with the proper operation of the ventilator 202. The monitor module 230 may communicate with display module 204, user interface 210, alarm display module 214, or other suitable modules or processors of the ventilator 202. Specifically, monitor module 230 may communicate with alarm display module 214 and/or display module 204 such that information regarding alarm events may be displayed to the clinician. Monitor module 230 may further utilize one or more sensors to detect changes in various physiological or mechanical parameters. Indeed, any sensory or derivative technique for monitoring the physical condition of the patient or the mechanical operation of the ventilator may be employed in accordance with embodiments described herein.
FIG. 3 is an illustration of an embodiment of a user interface 300 for hierarchically indicating alarms on a graphical display.
User interface may be accessed via any suitable means, for example via a main ventilatory user interface on display module. As illustrated, user interface may provide one or more windows for display and one or more elements for selection and/or input. Windows may include one or more elements and, additionally, may provide graphical displays, instructions, or other useful information to the clinician. Elements may be displayed as buttons, tabs, icons, toggles, or any other suitable visual access element, etc., including any suitable element for input selection or control.
User interface 300 may include various icons for controlling the ventilator. These icons are selectable elements wherein selection results in display of a new window. Some exemplary control icons include a setup icon 306, a tools icon 308, a log icon 310, an alarm adjustment icon 312, an oxygen concentration icon 314, and a help icon 316. While each of these icons controls ventilatory function, only the setup icon 306 and log icon 310 will be discussed in detail below in relation to indicating alarms on a ventilator display.
According to one embodiment, as illustrated in FIG. 3, a user interface 300 is provided that includes one or more hierarchically structured alarm tabs 302A-D. The alarm tabs 302A-D are selectable elements that provide a summarized alarm message. As depicted in user interface 300, the alarm tabs 302A-D are stacked one on top of another in a hierarchical structure on the right side of user interface 300. As will be appreciated by one skilled in the art, the alarm tabs can be located on any side of user interface 300 and can be arranged in any hierarchical structure as contemplated within the scope of the present disclosure. Furthermore, user interface 300 displays four alarm tabs 302A-D. As will also be appreciated by one skilled in the art, the user interface 300 may display any number of alarm tabs.
Each of the four alarm tabs 302A-D provides an alarm message that summarizes an alarm event 304A-D. An alarm event corresponds to a change in a ventilatory parameter that causes the controller 110 monitoring the parameter to issue an alarm. For example, alarm tab 302A provides an alarm message that summarizes an alarm event 304A related to the Peak Pressure parameter as indicated by the abbreviation “PPeak” on the alarm tab 302A. As also indicated on alarm tab 302A, the alarm event 304A that caused the alarm was an increase in Peak Pressure. This alarm event 304A is indicated on alarm tab 302A in two different manners. First, an upwards arrow next to the “PPeak” abbreviation signifies that Peak Pressure has increased. Second, the words “High Inspiratory Pressure” are also displayed on alarm tab 302A to signify the alarm event 304A. As will be appreciated by one skilled in the art, any number of methods of indicating an alarm event on an alarm tab is contemplated as within the scope of the present disclosure.
Each of the four alarm tabs 302A-D summarizes an alarm message that corresponds to an alarm event 304A-D that is different from the alarm event corresponding to another alarm tab 302A-D. As discussed above, alarm tab 302A corresponds to a “High Inspiratory Pressure” alarm event 304A. Alarm tab 302B, on the other hand, corresponds to “Low Exhaled Minute Volume” 304B.
Each alarm tab 302A-D also displays the alarm level associated with the alarm event 304A-D in the summarized alarm message. In one embodiment, the alarm levels are indicated by one or more exclamation points on the alarm tab. For example, user interface 300 displays three different alarm levels each indicated by different numbers of exclamation points. A “High” alarm level is indicated by three exclamation points (“!!!”). A “Medium” alarm level is indicated by two exclamation points (“!!”). A “Low” alarm level is indicated by one exclamation point (“!”). Furthermore, multiple methods of indicating alarm level can be simultaneously employed by user interface 300. For example, user interface might also color tabs differently based on alarm level. In one embodiment, an alarm tab with an alarm level of “High” is colored red, while alarm tabs with alarm levels of either “Medium” or “Low” are colored yellow. As can be appreciated by one skilled in the art, any symbol, color, or other method of alarm level indication can be used alone or in combination to indicate an alarm level.
Alarm tabs 302A-D are stacked on top of one another in a hierarchical structure based on the ranking of the alarm event 304A-D displayed by the alarm tab 302A-D. The ranking is derived from alarm level and parameter priority level. For the purpose of this disclosure, the alarm tab at the top of the stack, as exemplified by alarm tab 302A, is said to display the highest ranked alarm event. The alarm tab 302B below the alarm tab 302A displaying the highest ranked alarm event is said to display the second highest ranked alarm event. The alarm tab 302C below the alarm tab 30211 displaying the second highest ranked alarm event is said to display the third highest ranked alarm event. The alarm tab 302D below the alarm tab 302C displaying the third highest ranked alarm event is said to display the fourth highest ranked alarm event.
The ranking is derived from, first, the alarm level and second, if two alarm events have the same alarm level, from parameter priority level. An alarm event indicating an alarm level of “High” will be ranked higher than an alarm event indicating an alarm level of “Medium” which will be ranked higher than an alarm event indicating an alarm level of “Low.” As illustrated by user interface 300, alarm event 304A is associated with an alarm level of “High.” As a result, alarm event 304A is ranked higher than alarm events 302C and 302D that indicate alarm events with alarm levels of “Medium” and “Low” respectively. As will be discussed in greater detail below, alarm levels are parameter specific. In other words, measurements that cross a certain threshold for a first parameter may trigger a “Low” alarm level while measurements that cross the same threshold for a second parameter may trigger a “Medium” or “High” alarm level.
If two alarm tabs indicate alarm events with the same alarm level, the ranking of each alarm event is then derived from parameter priority level. A ventilator monitors a multitude of ventiltatory parameters. Each parameter is assigned a priority. The parameter priority level may be assigned by a clinician or based on uniform protocol at ventilator setup. The priority level associated with a parameter is stored by the ventilator in storage 114 or RAM 112 of the controller 110. In one embodiment, the parameter priority level can be changed by utilizing setup icon 306.
As illustrated in user interface 300, when two alarm events 302A and 302B have the same alarm level (“High”), one alarm event 302A is still ranked higher than the other alarm event 302B. In the case of exemplary user interface 300, alarm event 304A is ranked higher than alarm event 304B because parameter “PPeak” is assigned a higher priority than parameter “VE TOT.” As such, alarm event 304A is displayed in alarm tab 302A and alarm event 304B is displayed in alarm tab 304B.
An alarm level associated with an alarm event can increase or decrease over time. For example, a patient's condition may improve, causing the alarm level to either decrease or disappear entirely. This is known as alarm level de-elevation. Alternatively, a patient's condition may worsen, causing the alarm level to increase. This is known as alarm level elevation. When the ventilatory system detects a de-elevation or elevation of an alarm event, a clinician or other ventilatory user is notified of the change by a warning symbol superimposed on setup icon 306 and/or log icon 310. In one embodiment, the warning symbol is a yellow triangle, as exemplified in user interface 300. As will be appreciated by one skilled in the art, any symbol, word, sound, or other notification method may be used to notify the clinician that an alarm event has changed. It should be noted that a change in an alarm event may or may not be displayed on alarm tabs 302A-D depending on whether the alarm event is ranked high enough for display. The ventilator removes the warning symbol from an icon when clinician selects that icon. Selection of setup icon 306 causes user interface 300 to display alarm setup window 500. Alarm setup window 500 will be discussed in detail with regard to FIG. 5 below. Selection of log icon 310 causes user interface 300 to display alarm log window 600. Alarm log window 600 will be discussed in detail with regard to FIG. 6 below.
When an alarm level associated with an alarm event elevates to de-elevates, the change may trigger an increase or decrease in that alarm events ranking as well as the ranking of other alarm events. Changes to the ranking of alarm events necessitates that the alarm events be reordered in the user interface. As will be appreciated, reordering alarm events may cause the user interface 300 to display a previously undisplayed alarm event in an alarm tab or remove from display an alarm event previously displayed in an alarm tab.
As alarm events 304A-D are reordered in the hierarchical structure, the alarm tabs displaying the alarm events slide up and down passed one another to reflect the reordered alarm events. For example, the ventilator may detect an elevation in alarm level for alarm event 304D “High End Expiratory Pressure” from “Low” to “Medium.” The elevated alarm level results in two alarm events 304C and 304D with “Medium” alarm levels. To determine the ranking of each alarm event, the system compares the parameter priority of “%LEAK” to the parameter priority for “PEEP.” In one embodiment, “PEEP” has a higher parameter priority than “%LEAK.” As a result, the ranking of alarm event 304D associated with “PEEP” changes from fourth highest ranked to the third highest ranked. In a similar vein, the ranking of the alarm event 304C associated with “%LEAK” changes from third highest ranked to the fourth highest ranked. Reordering of the alarm events 304C and 304D is visualized in user interface 300 by sliding the reordered alarm tabs 302D and 302C up and down, respectively, to occupy the new ranking position. Alarm tab 302D displaying alarm event 304D slides up to occupy the location of alarm tab 302C. Likewise, alarm tab 302C displaying alarm event 304C slides down to occupy the location of alarm tab 302D. In one embodiment, alarm tab 302D slides straight up while alarm tab 302C may partially retract, or partially fade, while sliding by alarm tab 302D. The alarm tabs 302A-D on user interface 300 now properly reflect the rankings of alarm events 304A-D.
As illustrated in user interface 300, alarm tabs 302A-D may be displayed by default in a minimized state. The minimized state of the alarm tab 302A-D still conveys information such as alarm event 304A-D, parameter, alarm level and ranking while not occupying too much space on the user interface. Alarm tabs may 302A-D also include an arrow 318A-D indicating that the minimized alarm tab can be expanded. Making a selection, such as by clicking, anywhere in alarm tab 312A-D will cause the selected alarm tab to expand. Expanding an alarm tab will be discussed in detail with reference to FIG. 4.
FIG. 4 is an illustration of an embodiment of a user interface 400 for displaying an expanded alarm tab.
With reference to like numerals from FIG. 3, FIG. 4 illustrates a user interface 400 that includes an expanded alarm tab 402. The expanded alarm tab 402 is accessed by making a selection anywhere in alarm tab 302A. Upon making the selection, the maximization arrow 318A is flipped in the opposite direction to indicate that maximization arrow is now a minimization arrow 410. When a clinician wants to deflate the expanded alarm tab 402, the clinician may make a selection anywhere in expanded alarm tab 402 and the expanded alarm tab 402 is minimized back to alarm tab 302A. Upon minimization, the minimization arrow 410 is converted back into maximization arrow 318A. User interface 400 illustrates single expanded alarm tab 402. However, as will be appreciated by one skilled in the art, any number of alarm tabs 302A-D may be expanded or minimized at any given time for display in user interface 400.
In another embodiment, certain alarm tabs associated with very high priority alarm events may be automatically expanded upon detection of the alarm event. The very high priority alarm events may be indicated by a clinician or may be industry standards. Upon initial detection of the high priority alarm event, the alarm tab will expand immediately. The clinician can then choose to minimize the expanded alarm tabs by the any of the minimization methods as discussed above. This behavior of automatically expanding alarm tabs associated with very high priority alarm events has the added advantage of maximizing the visibility of the alarm. Because the expanded alarm tab may overlap other items on screen and thus interrupt on screen activity, the behavior, in one embodiment, may only be used on alarms that require immediate intervention. This may include alarm events associated with activity outside of the ventilatory parameters such as circuit disconnect, occlusion, etc.
As is illustrated in user interface 400, expanded alarm tab 402 provides clinician with more detailed information about the alarm event. In one embodiment, expanded alarm tab 402 provides clinician with an explanation 404 as to why an alarm event is associated with a particular alarm level. For example, expanded alarm tab 402 may provide an explanation 404 for the “High” alarm level associated with alarm event 302A, stating that “Last 4 Or More Breaths>=Set Limit.” This explanation 404 provides the clinician with a reason why the alarm level for the alarm event 304A is set to “High.”
Expanded alarm tab 402 may also provide clinician with possible solutions 406 that may de-elevate the alarm level associated with an alarm event 304A. For example, expanded alarm tab 402 may provide possible solutions 406 to increased Peak Pressure, suggesting “Check Patient, Circuit, and ET Tube.” These possible solutions 406 provide clinician with suggestions that may alleviate the problem and, as a result, de-elevate the alarm level associated with an alarm event.
Expanded alarm tab 402 may also provide the clinician with a hyperlink 408 to alarm setup window 500. The hyperlink 408 allows a clinician to “jump” to the alarm setup window 500 for that alarm without having to navigate to it through the setup icon 306.
FIG. 5 depicts an alarm setup window 500 for display in user interface 300. As discussed above, alarm setup window 500 may be accessed by selecting the hyperlink 408 in the expanded alarm tab 402. By selecting the hyperlink 408, a clinician is able to “jump” to the meter for the parameter associated with the selected alarm event. The alarm setup window 500 can also be accessed by selecting the setup icon 306 and navigating to the alarm setup window 500. As depicted by alarm setup window 500, alarm tabs 302A-D may still be visible when alarm setup window 500 is displayed.
Alarm setup window 500 displays a meter for each ventilatory parameter associated. It will be appreciated that only those alarms with user-adjustable parameters, i.e. those alarms associated with ventilatory parameters, may be associated with a meter in alarm setup window 500. Some alarms issued by the ventilator are not user-adjustable alarm such as an alarm indicating apnea, procedure error, or circuit disconnect. As discussed above, a ventilator monitors a multitude of ventilatory parameters. As such, alarm setup window 500 may display meters for parameters that are not visible on alarm tabs 302A-D in user interfere 300. Parameters may not be visible on alarm tabs 302A-D because either the parameter is not associated with an alarm event or, if the parameter is associated with an alarm event, the alarm event is not ranked high enough to be displayed in alarm tabs 302A-D. In either event, alarm setup window 500 allows a clinician to view a meter for each ventilatory parameter, whether that parameter is displayed in alarm tabs 302A-D or not.
Alarm setup window 500 displays five meters 504A-E, each meter associated with a different parameter. As discussed above, ventilator may monitor more or less than five parameters. Additional meters for parameters not currently displayed in alarm setup window 500 can be accessed using scroll bar 506. Scroll bar 506 includes multiple symbols, each symbol representing one parameter. In one embodiment, the symbols on the scroll bar 506 are bells. However, any symbol can be used within the scope of the present disclosure. Parameters associated with alarm events are further depicted on scroll bar 506 by superimposing an alarm event symbol onto the parameter symbol. As illustrated by scroll bar 506, the bells representing the parameter may be superimposed with a yellow triangle representing that the parameter is associated with an alarm event. Furthermore, the yellow triangle may include the number of exclamation points associated with the alarm level of the alarm event for that parameter. For example, a parameter with an alarm event of alarm level medium might be represented in scroll bar 506 as a bell with a yellow triangle superimposed onto in it, the yellow triangle including two exclamation points. Again, any method of representing alarm events, alarm levels, or parameters on a scroll bar 506, is contemplated within the scope of the present disclosure including differing colors, symbols, and graphical effects.
Scroll bar 506 may also include scroll bar window 508. Scroll bar window 508 encases the parameter symbols representing the parameters with meters currently displayed in alarm setup window 500. In one embodiment, alarm setup window 500 displays five meters 504A-E so scroll bar window encases five parameter symbols, 506A-E, representing the five meters. For example, the PPeak parameter meter 504A is displayed in the left most position of alarm setup window 500. The PPeak parameter meter 504A is, therefore, represented by symbol 506A in the left most position of scroll bar 506. The symbol 506A in the left most position of scroll bar 506 indicates that it represents a parameter associated with “High” level alarm event. This description matches the PPeak parameter which is associated with an “High” level alarm event, as indicated by alarm tab 302A.
Scroll bar window 508 can be shifted to the left or right on scroll bar 506 to display meters associated with different parameters. For example, a clinician may access scroll arrows 516 to shift scroll bar window 508 one position to the right on scroll bar 506. Such a shift would cause alarm setup window 500 to display parameters associated with symbols 506B-506F. The scroll bar window 508 can be shifted in either direction until the end of the scroll bar 506 is reached. Clinician can also access a meter for a parameter by directly selecting its symbol from scroll bar 506. For example, if clinician was interested in the “Medium” level alarm event associated with symbol 5061, the clinician could directly click on symbol 5061 and alarm setup window 500 would display five meters, one being the parameter associated with symbol 5061. In one embodiment, whenever the scroll bar 506 is accessed, whether by shifting the scroll bar window 508 using scroll bar arrows 516 or by clicking a symbol on scroll bar 506, scroll bar 506 illuminates to inform a clinician of the shift.
Each meter 504A-E displays ranges and measurements associated with a particular parameter. The big numbers 510A-I indicate either an upper or lower limit of a safe range for a given parameter. The safe range is the range in which parameter measurements for a patient indicate that the patient is not in danger. For example, the PPeak parameter has a safe range with an upper limit 510A of 40 cmH2O and a lower limit 510B of 14 cmH2O. The fTOT parameter, on the other hand, has a safe range with an upper limit 510C of 40 l/min but does not have any lower limit. As a result, only one limit is displayed in association with the fTOT parameter meter 504B.
The upper and lower limit for each meter 504A-E can be adjusted. For example a clinician can select the upper limit MOD and drag it up or down. When upper limit MOD is released at a new value, the big numbers inside upper limit 510D will change to reflect the new value. If an upper limit 510A, C, D, F, or H is dragged to the top of the meter, the upper limit may disappear, or read “OFF”. Likewise, if a lower limit 510B, E, G, or I is dragged to the bottom of the meter the lower limit may disappear, or read “OFF”. An upper limit 510A, C, D, F, or H can only be dragged as low as the lower limit for that meter. Likewise, a lower limit 510B, E, G, or I can only be dragged as high as the upper limit for that meter. In another embodiment, a meter may be associated with an alarm that has a factory preset limit and cannot be turned off.
The numbers 512A-D represent the current measurement for a given parameter. For example, the current measurement for the PPeak parameter is 40 cmH2O. The current measurement 512A-D is displayed as a line through a white box 514A-D in the meter 504A-D for the parameter. The white box 514A-D represents the measurements of the parameter for a given period. In one embodiment, the period is a period of time, such as two minutes, and the white box represents the measurements for the parameter for the last two minutes. In another embodiment, the period is a period of breaths, such as 200 breaths, and the white box represents the measurements for the parameter for the last 200 breaths. As will be appreciated by one skilled in the art any sort of period can be used to define the bounds of the white box.
As is illustrated in alarm setup window 500, some meters may not display any measurements. In one embodiment, a meter may not display any measurement because the alarm for the parameter associated with the meter may only be required under certain breath modes or breath types. For example, in alarm setup window 500, the meter for the parameter VTE SPONT does not display any measurements. This is because the current breath mode does not require VTE SPONT measurements. In one embodiment, the alarm setup window 500 will automatically switch and begin displaying measurements for the VTE SPONT parameter when the current breath mode changes.
Alarm setup window 500 may also include one or more controls for alarm volume. As illustrated in alarm setup window 500, alarm volume may be controlled by a volume adjust scrollbar 518. By sliding volume adjust scrollbar 518 either left or right, clinician can control the volume of an emitted alarm. Volume adjust scrollbar 518 may also display the current alarm value as a numerical value. As displayed by alarm setup window 500, the alarm volume may be based on a scale from one to ten. As will be appreciated by one skilled in the art, any scale or other manner of conveying alarm value may be used as contemplated within the scope of the present disclosure.
Alarm setup window 500 also includes a transparency button 522 and a pin-up button 524. When the transparency button 522 is accessed, the alarm setup window 500 may be viewed simultaneously with other data displayed on user interface 300, or other user interface. When the pin-up button 524 is accessed, the alarm setup window 500 may remain open unless and until a clinician desires to close the alarm setup window 500 by accessing the “Close” button 520. Otherwise, the alarm setup window 500 may close automatically after some period of inactivity. In another embodiment, the alarm setup window 500 will close, and the changes to the alarm limits will be implemented, when an “Accept” button (not depicted) is accessed. When the alarm setup window 500 is pinned and the “Accept” button (not depicted) is accessed, the changes will be implemented, but the alarm setup window 500 will not be closed.
FIG. 6 depicts an alarm log window 600 for display in user interface 300. As discussed above, selection of log icon 310 causes user interface 300 to display alarm log window 600. This selection is indicated by the bold box surrounding log icon 602. As will be appreciated, any manner of indicating selection may be used.
Alarm log window 600 provides a temporal log of alarm events. In one embodiment, the alarm log records all alarm events emitted since the last manual reset of the mechanical ventilator. In another embodiment, the alarm log records all alarm events emitted since the ventilator began monitoring a new patient. A variety of information categories related to alarm events may be provided by alarm log window 600. For example, alarm log window 600 may provide information categories regarding the time 604, event 606, priority 608, alarm 610, and analysis 612. These categories may be arranged as columns in a table. In other embodiments, some or different information categories associated with alarm events may be provided by alarm log window 600.
Alarm log window 600 may provide a time 604 information category indicating the time at which an alarm event occurred. In one embodiment, the alarm events are arranged hierarchically from the most recent event to the least recent event. The time 604 information category may be accompanied by a flip arrow 614. By accessing the flip arrow 614, a clinician may flip the order the alarm log hierarchy such that the alarm events are displayed from the least recent event to the most recent event.
Alarm log window 600 may also provide an event 606 information category indicating a type of alarm event. In one embodiment, there are three types of alarm events:
manual reset, augmented, and detected. However, it will be appreciated that there may be any number of alarm events. A manual reset alarm event may indicate that an alarm was manually reset by the operator pressing an alarm reset button on the ventilator. An augmented alarm event may indicate that an alarm has been escalated in priority. A detected alarm event may indicate that an alarm was first detected at that point in time.
Alarm log window 600 may also provide a priority 608 information category indicating an alarm level associated with an alarm event. As discussed above, an alarm event may be associated with an alarm level that reflects the severity of the alarm event. Exemplary alarm levels include high, medium, and low.
Alarm log window 600 may also provide an alarm 610 information category indicating a change in a parameter measurement associated with an alarm event. As discussed above, parameter names may be represented by parameter abbreviations. For example, Peak Pressure may be represented by the abbreviation “PPeak.” The parameter abbreviation may be accompanied by a symbol indicating the change in the parameter measurement. In one embodiment, the parameter abbreviation is accompanied by either an upward pointing arrow or a downward pointing arrow. For example, the “PPeak” parameter may be accompanied by an upward pointing arrow indicating that the Peak Pressure has increased.
Alarm log window 600 may also provide an analysis 612 information category indicating more detailed information about the cause of the alarm event. The alarm 612 information category may provide the measurement that triggered the alarm event. For example, if the ventilator measures the last 4 or more breaths of the patient as greater than or equal to the set limit, the ventilator may trigger an increased Peak Pressure alarm event with a high alarm level.
Alarm log window 600 may also include a scroll bar 622. By accessing the scroll bar 622, a clinician can display different alarm events in the alarm log window 600. In one embodiment, when the scroll bar 622 is accessed it is illuminated to indicate to the clinician that the alarm events displayed in the alarm log window 600 have changed.
Alarm log window 600 may also include a transparency button 616 and a pin-up button 618. When the transparency button 616 is accessed, the alarm log window 600 may be viewed simultaneously with other data displayed on user interface 300, or other user interface. When the pin-up button 618 is accessed, the alarm log window 600 may remain open unless and until a clinician desires to close the alarm log window 600 by accessing the “Close” button 620. Otherwise, the alarm log window 600 may close automatically after some period of inactivity. When the alarm log window 600 is pinned, the changes will be implemented, but the alarm log window 600 will not be closed.
It will be clear that the systems and methods described herein are well adapted to attain the ends and advantages mentioned as well as those inherent therein. Those skilled in the art will recognize that the methods and systems within this specification may be implemented in many manners and as such is not to be limited by the foregoing exemplified embodiments and examples. In other words, functional elements being performed by a single or multiple components, in various combinations of hardware and software, and individual functions can be distributed among software applications at either the client or server level. In this regard, any number of the features of the different embodiments described herein may be combined into one single embodiment and alternative embodiments having fewer than or more than all of the features herein described are possible.
While various embodiments have been described for purposes of this disclosure, various changes and modifications may be made which are well within the scope of the present invention. Numerous other changes may be made which will readily suggest themselves to those skilled in the art and which are encompassed in the spirit of the disclosure and as defined in the appended claims.

## Claims

1. A ventilator system for hierarchically indicating one or more alarm messages corresponding to an alarm event, the ventilator system configured with a computer having a processor and a memory, the memory communicatively coupled to the processor and storing instructions that when executed by the processor cause the ventilator system to provide a graphical user interface for accepting commands and for displaying information, the graphical user interface comprising:
at least one window associated with the graphical user interface; and
one or more elements within the at least one window comprising one or more of:
a first meter element for indicating a first parameter, the first parameter having a first parameter priority level;
a second meter element for indicating a second parameter, the second parameter having a second parameter priority level;
a scroll bar element, wherein the scroll bar is provided below the first meter element and the second meter element, the scroll bar element displaying at least:
a first parameter symbol associated with the first parameter;

a first alarm event symbol superimposed on the first parameter symbol, wherein the first alarm event symbol identifies a first alarm event associated with the first parameter, wherein the first alarm event has a first alarm level;
a second parameter symbol associated with the second parameter: and
a second alarm event symbol superimposed on the second parameter symbol, wherein the second alarm event symbol identifies a second alarm event associated with the second parameter, wherein the second alarm event has a second alarm level, and wherein the first alarm level is ranked higher than the second alarm level.

2. The ventilator system of claim 1, wherein the second parameter priority level is higher than the first parameter priority level.

3. The ventilator system of claim 2, wherein the ventilator receives an indication that the second alarm level has increased such that the second alarm level equals the first alarm level.

4. The ventilator system of claim 3, wherein the second parameter priority level is compared to the first parameter priority level.

5. The ventilator system of claim 4, wherein a determination is made that the second alarm event is now ranked higher than the first alarm event.

6. The ventilator system of claim 5, wherein the scroll bar displays an indication that the second alarm event is ranked higher than the first alarm event.

7. The ventilator system of claim 1, wherein the scroll bar further comprises a scroll bar window.

8. The ventilator system of claim 7, wherein the scroll bar window encases parameter symbols for one or more parameters for which parameter meters are displayed within the at least one window.

9. The ventilator system of claim 7, wherein the scroll bar window encases at least the first parameter symbol and the second parameter symbol.

10. The ventilator system of claim 1, wherein the scroll bar further comprises a scroll bar window, wherein the scroll bar window encases at least the first alarm symbol superimposed on the first parameter symbol and the second alarm symbol superimposed on the second parameter symbol.

11. The ventilator system of claim 1, wherein the scroll bar further displays:
a third parameter symbol associated with a third parameter; and
a fourth parameter symbol associated with a fourth parameter, wherein a meter element is not displayed within the at least one window for the third parameter or for the fourth parameter.

12. The ventilator system of claim 11, wherein the scroll bar further comprises a scroll bar window encasing the first parameter symbol and the second parameter symbol and not the third parameter symbol and the fourth parameter symbol.

13. A non-transitory computer-readable storage medium having instructions that when executed cause a ventilator to provide a graphical user interface for accepting commands and for displaying information, the graphical user interface comprising:
at least one window associated with the graphical user interface; and
one or more elements within the at least one window comprising one or more of: a first meter element for indicating a first parameter, the first parameter having a first parameter priority level; and
a second meter element for indicating a second parameter, the second parameter having a second parameter priority level;
a scroll bar element, wherein the scroll bar is provided below the first meter element and the second meter element, the scroll bar element displaying at least:
a first parameter symbol associated with the first parameter;
a first alarm event symbol superimposed on the first parameter symbol, wherein the first alarm event symbol identifies a first alarm event associated with the first parameter, wherein the first alarm event has a first alarm level;
a second parameter symbol associated with the second parameter;
a second alarm event symbol superimposed on the second parameter symbol, wherein the second alarm event symbol identifies a second alarm event associated with the second parameter,
wherein the second alarm event has a second alarm level, and wherein the first alarm level is ranked higher than the second alarm level.

14. The non-transitory computer-readable storage medium of claim 13, wherein the non-transitory computer-readable storage medium is selected from: RAM, ROM, EPROM, EEPROM, flash memory, solid state memory technology, CD-ROM, DVD, optical storage, magnetic cassettes, magnetic tape, and magnetic disk storage.

15. The non-transitory computer-readable storage medium of claim 13, wherein the scroll bar further comprises a scroll bar window.

16. The non-transitory computer-readable storage medium of claim 15, wherein the scroll bar window encases parameter symbols for one or more parameters for which parameter meters are displayed within the at least one window.

17. The non-transitory computer-readable storage medium of claim 15, wherein the scroll bar window encases at least the first parameter symbol and the second parameter symbol.